Do noradrenergic reuptake inhibitors affect serotonergic function in depression?
d-Fenfluramine, a specific 5-HT releasing agent without the catecholamine effects of d,l-fenfluramine, was used as a serotonergic neuroendocrine challenge in subjects with unipolar major depression. Prolactin and cortisol responses to 30 mg d-fenfluramine were measured in patients at baseline. Patients were then randomly assigned to treatment for 6 weeks with a specific noradrenergic reuptake inhibitor, a tricyclic antidepressant, or placebo. Response to antidepressant treatment was assessed, and patients underwent further testing with d-fenfluramine. Prolactin responses were increased by treatment, but this was independent of whether or not patients' depression responded to treatment. Seven patients were treated with a specific noradrenergic reuptake inhibitor. These patients showed a significant rise in 5-HT-mediated cortisol responses after treatment, independent of whether their depression improved. We conclude that antidepressants which selectively modify noradrenergic function also have effects on 5-HT function as measured by neuroendocrine testing.
Cleare
A J
AJ
Department of Psychological Medicine, Institute of Psychiatry, London, UK.
Murray
R M
RM
O'Keane
V
V
D018759:Adrenergic Uptake Inhibitors / Q000494:pharmacology*; D000328:Adult; D019540:Area Under Curve; D003866:Depressive Disorder / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D009638:Norepinephrine / Q000502:physiology*; D011388:Prolactin / Q000097:blood; D012701:Serotonin / Q000502:physiology*
D018759:Adrenergic Uptake Inhibitors; D012701:Serotonin; D011388:Prolactin; D006854:Hydrocortisone; D009638:Norepinephrine